Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial

Eborall, Helen; Griffin, Simon J.; Prevost, A. Toby; Kinmonth, Ann Louise; French, David P.; Sutton, Stephen

doi:10.1136/bmj.39303.723449.55

Cited by 123 publications

(140 citation statements)

References 24 publications

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“…Modelling studies suggest that screening might be both effective and costeffective [1][2][3][4][5]. Screening and early treatment for diabetes appear to be associated with limited harms [6,7]. Health check programmes including diabetes risk assessment have been proposed or introduced in a number of countries [8,9].…”

Section: Introductionmentioning

confidence: 99%

Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009

et al. 2017

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Aims/hypothesis There is continuing debate about the net benefits of population screening for type 2 diabetes. We compared the risk of cardiovascular disease (CVD) and mortality among incident cases of type 2 diabetes in a screened group with those in an unscreened group. Methods In this register-based non-randomised controlled trial, eligible individuals were all men and women aged 40-69 years without known diabetes, registered with a general practice in Denmark (n = 1,912,392). Conclusions/interpretation A single round of diabetes screening and cardiovascular risk assessment in middle-aged Danish adults in general practice was associated with a significant reduction in risk of all-cause mortality and CVD events in those diagnosed with diabetes.

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Section: Introductionmentioning

confidence: 99%

Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009

et al. 2017

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“…Recently, studies in Europe and the USA have specifically explored the psychological effects of undergoing screening for Type 2 Diabetes and these tend to support the conclusions of Marteau's work. Some studies have assessed the impact of screening by asking patients to complete rating scales that measure their levels of anxiety, depression, and disease-specific worry (Eborall et al, 2007a;Park et al, 2008), or their health-related quality of life (Edelman et al, 2002b). Such studies have generally found no lasting or significant adverse psychological effects in terms of anxiety, depression, worry, or perceived quality of life after screening.…”

Section: The St Leonard's Practice Approach To Screening For Type 2 Dmentioning

confidence: 99%

Type 2 Diabetes Mellitus in Family Practice: Prevention and Screening

Evans¹,

Wright²,

Gray³

et al. 2011

Topics in the Prevention, Treatment and Complications of Type 2 Diabetes

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“…Adverse effects, i.g. anxiety, depression, and a decreased quality of life, appear to be minimal regardless of the diagnosis (Adriaanse & Snoek, 2006;Eborall et al, 2007a;Paddison et al, 2011). However, the absence of adverse effects may stem merely from people's tendency not to regard diabetes as a serious disease (Adriaanse et al, 2002;Eborall, Davies, Kinmonth, Griffin, & Lawton, 2007b;Skinner et al, 2006), or to have a low risk perception, due for example to an optimistic bias (Jones, Roche, & Appel, 2009;Kemple, Zlot, & Leman, 2005;Kim et al, 2007).…”

Section: *Statement Of Contributionmentioning

confidence: 99%

‘I saw what the future direction would be…’: Experiences of diabetes risk and physical activity after diabetes screening

Vähäsarja

Kasila

Kettunen

et al. 2014

British J Health Psychol

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Objectives To improve understanding of how individuals at high risk of type 2 diabetes experience the risk of diabetes and how these experiences relate to the adoption of physical activity as a protective behaviour. Design A qualitative study using semi‐structured interview with individuals identified by screening as at high risk of type 2 diabetes. Methods Fourteen individuals, aged 40–64, were interviewed twice, with a 2‐year interval between. Participants' experiences of their risk of diabetes and physical activity were assessed. The transcribed interview data were analysed using inductive qualitative content analysis. Results Two themes emerged from the data: a threatening risk perception and a rejected risk perception. The threatening risk perception occurred when the risk was unexpected by the participant, but became internalized through the screening procedure. The threatening perception also involved a commitment to increase physical activity to prevent diabetes. However, short‐term anxiety and subsequently emerging hopelessness were also part of this perception. The rejected risk perception involved indifference and scepticism regarding the risk. Here, physical activity behaviour and cognitions appeared to remain unchanged. Rejection also involved difficulties in accepting one's high‐risk identity. The rejecting group lacked motivation for increased physical activity, while the other group showed determination regarding increased physical activity, often leading to success. Conclusion Perceptions of the risk of diabetes emerged as threatening or as rejected. Participants' perceptions reflected varying and intertwining emotional, cognitive, and behavioural mechanisms for coping with the risk, all of which should be recognized in promoting physical activity among high‐risk individuals. What is already known on this subject? Diabetes screening has few adverse psychological effects on screened individuals. Diabetes can be prevented by increased physical activity and modest weight loss among high‐risk individuals. The evidence on the effects of screening on protective behaviour is limited and inconsistent.What does this study add? High‐risk individuals' threatening perception of risk appears encouraging increased physical activity. Individuals having problems in adjusting to high‐risk identification may not be motivated to engage in physical activity for prevention. Failure to achieve the outcomes expected from lifestyle changes may lead people with threatening risk perception to a sense of hopelessness.

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Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial

Cited by 123 publications

References 24 publications

Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009

Effect of screening for type 2 diabetes on risk of cardiovascular disease and mortality: a controlled trial among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009

Type 2 Diabetes Mellitus in Family Practice: Prevention and Screening

‘I saw what the future direction would be…’: Experiences of diabetes risk and physical activity after diabetes screening

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